Effects of regular aspirin on long-term cancer incidence and metastasis: a systematic comparison of evidence from observational studies versus randomised trials
The Lancet Oncology,  Clinical Article

Algra AM et al. – Observational studies show that regular use of aspirin reduces the long-term risk of several cancers and the risk of distant metastasis.

Methods

  • Case—control and cohort studies published from 1950 to 2011 that reported associations between aspirin use and risk or outcome of cancer were searched.
  • Associations were pooled across studies by meta-analysis and stratified by duration, dose, and frequency of aspirin use and by stage of cancer.
  • We compared associations from observational studies with the effect of aspirin on 20-year risk of cancer death and on metastasis in the recent reports of randomised trials.

Results
  • In case—control studies, regular use of aspirin was associated with reduced risk of colorectal cancer (pooled odds ratio [OR] 0·62, 95% CI 0·58—0·67, psig<0·0001, 17 studies), with little heterogeneity (phet=0·13) in effect between studies, and good agreement with the effect of daily aspirin use on 20-year risk of death due to colorectal cancer from the randomised trials (OR 0·58, 95% CI 0·44—0·78, psig=0·0002, phet=0·45).
  • Similarly consistent reductions were seen in risks of oesophageal, gastric, biliary, and breast cancer.
  • Overall, estimates of effect of aspirin on individual cancers in case—control studies were highly correlated with those in randomised trials (r2=0·71, p=0·0006), with largest effects on risk of gastrointestinal cancers (case—control studies, OR 0·62, 95% CI 0·55—0·70, p<0·0001, 41 studies; randomised trials, OR 0·54, 95% CI 0·42—0·70, p<0·0001).
  • Estimates of effects in cohort studies were similar when analyses were stratified by frequency and duration of aspirin use, were based on updated assessments of use during follow-up, and were appropriately adjusted for baseline characteristics.
  • Although fewer observational studies stratified analyses by the stage of cancer at diagnosis, regular use of aspirin was associated with a reduced proportion of cancers with distant metastasis (OR 0·69, 95% CI 0·57—0·83, psig<0·0001, phet=0·89, five studies), but not with any reduction in regional spread (OR 0·98, 95% CI 0·88—1·09, psig=0·71, phet=0·88, seven studies), consistent again with the findings in randomised trials.

Please login or register to follow this author.
Are you sure you want to Unfollow this Author?
► Click here to access PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Oncology

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Oncology Articles

1 Randomized phase III trial of erlotinib versus docetaxel as second- or third-line therapy in patients with advanced non-small-cell lung cancer: Docetaxel and Erlotinib Lung Cancer Trial (DELTA) Journal of Clinical Oncology, May 29, 2014    Clinical Article

2 Ibrutinib versus ofatumumab in previously treated chronic lymphoid leukemia New England Journal of Medicine, June 4, 2014    Evidence Based Medicine    Clinical Article

3 Effect of radiotherapy after mastectomy and axillary surgery on 10-year recurrence and 20-year breast cancer mortality: meta-analysis of individual patient data for 8135 women in 22 randomised trials The Lancet, March 25, 2014    Evidence Based Medicine    Clinical Article

4 A randomised phase II study of pemetrexed versus pemetrexed+erlotinib as second-line treatment for locally advanced or metastatic non-squamous non-small cell lung cancer European Journal of Cancer, May 23, 2014    Clinical Article

5 Rituximab versus a watch-and-wait approach in patients with advanced-stage, asymptomatic, non-bulky follicular lymphoma: an open-label randomised phase 3 trial The Lancet Oncology, March 7, 2014    Clinical Article

6 Survival of women with inflammatory breast cancer: A large population based study Annals of Oncology, April 16, 2014    Clinical Article

7 Coffee intake and gastric cancer risk Cancer Epidemiology, Biomarkers & Prevention, March 20, 2014    Clinical Article

8 Prevention and management of chemotherapy-induced peripheral neuropathy in survivors of adult cancers: American Society of Clinical Oncology Clinical Practice Guideline Journal of Clinical Oncology, May 5, 2014    Clinical Guideline

9 Panitumumab versus cetuximab in patients with chemotherapy-refractory wild-type KRAS exon 2 metastatic colorectal cancer (ASPECCT): a randomised, multicentre, open-label, non-inferiority phase 3 study The Lancet Oncology, May 27, 2014    Clinical Article

10 Radiotherapy of follicular lymphoma: updated role and new rules Current Treatment Options in Oncology, May 16, 2014    Clinical Guideline    Clinical Article

11 Adjuvant exemestane with ovarian suppression in premenopausal breast cancer New England Journal of Medicine, June 9, 2014    Evidence Based Medicine    Clinical Article

12 Everolimus for women with trastuzumab-resistant, HER2-positive, advanced breast cancer (BOLERO-3): a randomised, double-blind, placebo-controlled phase 3 trial The Lancet Oncology, May 27, 2014    Clinical Article

13 Open versus laparoscopic surgery for mid-rectal or low-rectal cancer after neoadjuvant chemoradiotherapy (COREAN trial): survival outcomes of an open-label, non-inferiority, randomised controlled trial The Lancet Oncology, June 11, 2014    Clinical Article

14 Oral contraceptives, hormone replacement therapy and breast cancer risk: A cohort study of 16 928 women 48 years and older Acta Oncologica, May 22, 2014    Clinical Article

15 Resistance mechanisms for the Bruton's tyrosine kinase inhibitor ibrutinib New England Journal of Medicine, June 3, 2014    Evidence Based Medicine    Clinical Article

16 PEAK: A randomized, multicenter phase II study of panitumumab plus modified fluorouracil, leucovorin, and oxaliplatin (mFOLFOX6) or bevacizumab plus mFOLFOX6 in patients with previously untreated, unresectable, wild-type KRAS exon 2 metastatic colorectal cancer Journal of Clinical Oncology, May 9, 2014    Clinical Article

17 Exposure to infections and risk of leukemia in young children Cancer Epidemiology, Biomarkers & Prevention, May 6, 2014    Clinical Article

18 Underuse of trimodality treatment affects survival for patients with inflammatory breast cancer: an analysis of treatment and survival trends from the National Cancer Database Journal of Clinical Oncology, June 13, 2014    Clinical Article

19 Risk of late effects of treatment in children newly diagnosed with standard-risk acute lymphoblastic leukaemia: a report from the Childhood Cancer Survivor Study cohort The Lancet Oncology, June 20, 2014    Clinical Article

20 Coffee intake and gastric cancer risk Cancer Epidemiology, Biomarkers & Prevention, March 11, 2014    Clinical Article

Indexed Journals in Oncology: Journal of Clinical Oncology, Cancer Research, Annals Oncologymore

Register now to view all the MDLinx contents (FREE)!

  • Stay current on the latest literature, research and clinical news
  • Get special communications and offers from MDLinx and our sponsors
  • Receive invitations to paid market research
View Samples and Register

Connect with us, stay current.

Receive the latest mecial news
updates for free via email

Sign up!

Subscribe to our free RSS feeds:

Get the latest news in your specialty automatically added to your newsreader or your personal My Yahoo!, Google, My MSN or My AOL page. Learn More

Close